Recognizing you have a problem is the first step. If you think you may be misusing a substance, let a member of your cystic fibrosis care team know. They can help you identify the underlying causes of your misuse, as well as triggers for substance misuse behaviors.
By starting the conversation, your care team can help you figure out what may be contributing to your stress. They can partner with you to find possible solutions, including ways to practice self-care and build resilience to cope with setbacks or changes in your life.
Admitting to someone that you may have a substance misuse problem takes courage. To help with the conversation, you might tell a member of your care team with whom you have a good relationship. It might also help to bring a person you trust for support.
If you don't want to talk to your CF care team, you can speak with your primary care physician. You can also try the Substance Abuse and Mental Health Services Administration (SAMHSA) national helpline at 800-662-HELP (800-662-4357). If you feel you need help with substance misuse, the important thing is to be honest and to keep asking until you get the help you need.
Here are some ways to start the conversation with a member of your care team:
- Lately, I find myself worrying more than usual …
- I've been having trouble getting to sleep without …
Not everybody feels ready or able to stop misusing substances entirely. You can ask your care team about ways you can lower the risks to your health, including:
- Cutting down the number of alcoholic drinks you have in one day or on the number of days you drink in a week
- Avoiding inhaled substances
- Limiting or temporarily stopping substance misuse when you are feeling unwell, such as during a pulmonary exacerbation
Many people hesitate to talk to their care teams because they are afraid of being judged or denied care. They may not even realize the effects of their substance misuse on their health due to things like drug-to-drug interactions. It is important to remember that you're more likely to get the right care if you start the conversation.
“When my nurse coordinator mentioned therapy, I was hesitant. I told myself, and her, that I wasn't crazy (because only crazy people go to therapy?) and that I could get through this, just like I had gotten through everything else. But the truth was I couldn't get through it alone, and once I realized that, it was like a huge weight had been lifted off my shoulders.” Jessika Allison, adult with CF
Read more about Jessika's experience.
There are many options for substance misuse treatment, and whatever you decide should be tailored for your unique needs, such as how severe your substance misuse is. Treatment for substance misuse includes:
- Behavioral treatment
- Outpatient or inpatient treatment
- Peer support
Your care team, or the substance misuse expert your care team refers you to, should help develop a recovery plan that works for you.
Anne Clark, whose daughter Kate had CF and substance misuse issues, talks about the importance of care teams treating mental health issues as well as CF.
Behavioral treatment (talk therapy) has been shown to help people with substance misuse issues. Many people find working with a health professional to identify and change the behaviors that lead to substance misuse can help. This includes:
- Developing skills that help to stop or reduce substance misuse
- Building a social support system
- Setting realistic goals
- Learning coping skills that can help identify and avoid triggers
Behavioral treatment can also help address other emotional issues, such as anxiety or depression.
Your doctor can also prescribe medications to help you stop misusing substances, including:
- Methadone, acamprosate (Campral®), and buprenorphine (Subutex®) for opioid dependence
- Disulfiram (Antabuse®) and naltrexone (ReVia®, Vivitrol®) for alcohol dependence
- Naltrexone is also used for opioid dependence and can be used in combination with buprenorphine (Buprenex®, Suboxone®)
Addiction treatment also includes long-term follow-up to prevent relapse.
In addition to medical and behavioral treatments, many people have found success recovering from addiction by joining a peer support program, such as a 12-step recovery program. Almost all 12-step programs are modeled on Alcoholics Anonymous. Twelve-step recovery programs include:
For people who feel the structure and methods of 12-step programs are not a good fit for them, there are also other effective recovery programs. Several mobile applications are available that can help in substance use disorder recovery.
Slips and Relapses
Addiction can be a long-term condition that may include slips and relapses. A slip is a brief return to misusing substances. A person might drink or use drugs once but stop soon after. A relapse is a return to misusing substances after a period of recovery.
Many people experience a sense of failure after a slip or relapse, but these setbacks do not need to end a person's intention to stay sober. In fact, it could motivate a person even more to sustain their recovery.
Many experts are starting to see substance use disorders as a chronic, long-term condition much like high blood pressure or diabetes, which are diseases that flare up and need treatment. If you do experience a slip or relapse, the important thing is to be honest with yourself and your support network, which can be your family, your 12-step sponsor, your counselor, members of your care team, or an online support group.
Practicing healthier coping skills so that they are habit-forming can reduce the probability of slips and relapses. Studies of tobacco smokers have shown that the more a person tries or practices the act of not smoking by replacing the urge with a less harmful activity, the more likely they are to ultimately quit smoking in the long term.
No matter how effective substance misuse treatment is, there will still be aspects of life that people who don't have CF won't understand. CF Peer Connect is a peer mentoring program for people with CF and their family members age 16 and older. Talk with and learn from someone who is also affected by CF and has gone through similar experiences.
One of the best ways to prevent relapse is to know the signs. Typically, that means understanding what triggers you to misuse substances. Triggers are things that cause cravings for the substance in your brain. They can include:
- Seeing a substance
- Seeing people use a substance
- People (those you used substances with in the past), places (such as a bar where you used to drink), or situations (finishing a work project) in which you used substances in the past
- Stressful emotions (hunger, anger, loneliness, or fatigue)
- Physical feelings (shakiness or tension)
Often, simple acts that divert you from thinking about the trigger can help the craving pass. For example, after identifying triggers, you can react to them in a healthy way, such as:
- Calling a friend you can talk to about being triggered
- Taking a walk
- Making a gratitude list
- Writing in a journal
Most health insurance policies cover treatment related to substance misuse. Specific coverage depends on if your insurance is private, public, or if you have no insurance. CF Foundation Compass case managers can assist you with identifying local resources based on the substance being used and the community programs available.
If you need help with substance misuse treatment, you can contact Compass, a free and personalized service that can help you with insurance, financial, legal, and other issues. Case managers can assist with identifying local resources, as well as help you identify your benefits and put you in touch with resources.
Contact CF Foundation Compass at:
Monday through Friday, 9 a.m. until 7 p.m. ET
Reference to any specific product, process, or service does not necessarily constitute or imply its endorsement, recommendation, or favoring by the Cystic Fibrosis Foundation. The appearance of external hyperlinks does not constitute endorsement by the Cystic Fibrosis Foundation of the linked websites, or information, products, or services contained therein.
Information contained on this site does not cover all possible uses, actions, precautions, side effects, or interactions. This site is not intended as a substitute for treatment advice from a medical professional. Consult your doctor before making any changes to your treatment.
FDA-approved drug information is available at dailymed.nlm.nih.gov/dailymed.
1. Richards CJ, Pinsky H, Yonker LM, Friedman D, Georgiopoulos AM. Alcohol and Opiate Misuse in Adults with Cystic Fibrosis [NACFC 2018 Accepted Abstract]. (Back to text)
2. Weitzman ER, Ziemnik RE, Haung Q, Levy S. Alcohol and Marijuana Use and Treatment Nonadherence Among Medically Vulnerable Youth. Pediatrics. 2015 Sep;136(3);450-7. (Back to text)
3. Quittner AL, Goldbeck L, Abbott J, et al. Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries. Thorax. 2014 Dec;69(12):1090-7. (Back to text)